Low cerebral spinal fluid pressure may be associated with open-angle glaucoma

Researchers measured cerebrospinal fluid pressure (CSF-P) and IOP in 43 patients with open-angle glaucoma (14 with normal IOP and 29 with elevated IOP) and 71 subjects without glaucoma. They found that CSF-P was significantly lower in the normal IOP glaucoma group than in the high IOP glaucoma group (9.5 mmHg versus 11.7 mmHg; P<0.001) or in the control group (1.4 mmHg). Also, the trans-lamina cribrosa pressure difference, calculated as the difference of IOP minus CSF-P, was significantly higher in normal-pressure and high-pressure glaucoma than in the control group. In the nonglaucomatous control group, CSF-P was significantly associated with systolic blood pressure and IOP, and IOP showed a tendency toward association with blood pressure.

The authors concluded that a high trans-lamina cribrosa pressure difference may play a role in this type of glaucoma, and that these patients might benefit from drugs that lower CSF-P, such as systemic carbonic anhydrase inhibitors.